Tuesday, September 25, 2007

Car Smoking Ban Supporters Call Smoking in Cars Worse Than Child Abuse, State that Secondhand Smoke is as Bad as Active Smoking

According to an article in Newsday, two New York legislators who are supporting the state's proposed ban on smoking in cars carrying children under 16 years of age have issued the following one-two punch of arguments in support of their position:

Assemblyman Ivan Lafayette, the sponsor of the car smoking ban bill, was quoted as stating that smoking in a car with a child is worse than child abuse (slapping a child in the face): "I think smoking in a car with a child has a more lasting effect than giving a child a slap in the face," said Assemblyman Ivan Lafayette, D-Queens. "They're both horrible things, but one is going to kill the child ... I know that's a hard comparison, but that's the reality of it."

Assemblywoman Sandra Galef, who is sponsoring a separate bill which would ban smoking in playgrounds, stated: "The scientific reports say that secondhand smoke has as much of a negative effect on your health as smoking directly. And we certainly want to be sure we keep smoke away from children who don't have the opportunity to walk away from it, and I think adults have to learn more responsible behavior around children."

The Rest of the Story

What more can I say about Assemblyman Lafayette's statement than to condemn it as being disgusting and completely insensitive to, and dismissive of, all those who have been victims of child abuse.

How can one suggest that physically abusing a child is no worse than exposing a child to secondhand smoke? How can one suggest that physically abusing a child results in effects that last for a much shorter time than a child breathing in secondhand smoke?

Anyone who has experienced abuse as a child or treated victims knows that the effects of childhood physical abuse last a lifetime. Anyone who is abused suffers harm. That harm is severe and in some respects irreparable.

In contrast, the majority of children who are exposed to secondhand smoke in cars do not suffer any long-term effects. There is an increased risk of ear infections and lower respiratory tract infections. But to compare that to child abuse?

It appears that at least some car smoking ban supporters are having a difficult time making a distinction between risk and harm. While physically abusing a child causes immediate, direct, severe, and intentional harm, smoking around a child merely increases the risk of adverse health consequences. And in almost all cases, that increased risk is not intentional.

To equate intentional infliction of direct injury with the unintentional imposition of increased health risks is unwarranted.

And in this case, it is also disrespectful, insensitive, and damaging.

Is this what is really behind car smoking bans? It has to make you wonder.

While not disgusting or insensitive, Assemblywoman Galef's argument is scientific rubbish. It is manifestly untrue that secondhand smoke exposure is as bad as active smoking. Clearly, active smoking has a far more detrimental effect on one's health than secondhand smoke exposure.

The relative risk of lung cancer associated with active smoking is about 17, yet only about 1.3 for passive smoking. Active smoking is a major cause of emphysema and chronic bronchitis (chronic obstructive lung disease), while secondhand smoke has not yet been shown to cause these conditions. Active smoking causes cancer of many other organs besides the lung, while secondhand smoke has been shown to be a cause only of lung and nasal sinus cancer.

To suggest that secondhand smoke is as harmful as active smoking is to undermine the public's appreciation of the hazards of active smoking. Do we really want smokers to believe that the health effects of their smoking are really only as bad as if they were exposed to secondhand smoke? A statement like that may generate headlines and scare people into supporting a car smoking ban, but it is false and damaging to public health messages about the hazards of smoking.

Of course, another problem with Galef's argument is that children cannot walk away from secondhand smoke in the home either. So if secondhand smoke is really as bad as active smoking, then how can we possibly allow parents to smoke around their children in the home? The New York smoking ban legislation chooses not to regulate smoking in the home, allowing parents to hold their kids captive and expose them to the equivalent of active smoking.

Why is it that parents must learn "more responsible behavior around children" in their cars, but not in their homes? Is it the harm being done to children that bothers our legislators, or is it just seeing the parents smoking that is the problem?

When one sees arguments in favor of a public policy deteriorate to this level, one should take a good hard look at the validity of the position in support of the policy. If this is the best that supporters can come up with, then I'm afraid I cannot find their position to be at all compelling.

One thing is for certain: the arguments being advanced by these car smoking ban proponents do cause harm. Harm to real victims of child abuse. And harm to public health efforts to educate the public about the hazards of smoking.

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About Me

Dr. Siegel is a Professor in the Department of Community Health Sciences, Boston University School of Public Health. He has 25 years of experience in the field of tobacco control. He previously spent two years working at the Office on Smoking and Health at CDC, where he conducted research on secondhand smoke and cigarette advertising. He has published nearly 70 papers related to tobacco. He testified in the landmark Engle lawsuit against the tobacco companies, which resulted in an unprecedented $145 billion verdict against the industry. He teaches social and behavioral sciences, mass communication and public health, and public health advocacy in the Masters of Public Health program.